Original Article T-Cell Responses to Islet Antigens Improves Detection of Autoimmune Diabetes and Identifies Patients With More Severe -Cell Lesions in Phenotypic Type 2 Diabetes

Latent autoimmune diabetes in adults or type 1.5 diabetes is considered to be a T-cell–mediated autoimmune disease. However, identification of patients is based commonly on autoantibody (Ab) detection. To determine whether mea-suring T-cell reactivity to islet proteins compared with measuring Abs improves detection of autoimmune diabetes and how -cell function correlates with T-cell reactivity compared with Ab positivity, we assessed the T-cell prolif-erative responses and Ab responses (islet cell autoantibod-ies, insulin autoantibodies, insulinoma-associated protein-2 autoantibodies, and GAD Abs) to islet proteins of 36 phenotypic type 2 diabetic patients. To be considered Ab or T-cell, patients were required to be positive for a minimum of two consecutive time points. -Cell function was measured with fasting and glucagon-stimulated C